Surely the disease of Rheumatoid arthritis (RA) needs no introduction. It is a chronic, systemic inflammatory disorder that has the capacity to affect many tissues and organs, but mainly attacks the joints producing an inflammatory synovitis that often progresses to destruction of the articular cartilage and ankylosis of the joints.

Apart from this, the disease is also known to lead to an assortment of problems, especially diffusion of inflammation in the lungs, pericardium, pleura, and sclera, and also nodular lesions, most common in subcutaneous tissue under the skin.

What is more, even though the cause of rheumatoid arthritis is obscure yet, autoimmunity plays a decisive role in its chronicity and progression.

Perhaps, in spite of naivety in the past, you have got some info by now. Let's make other facts clear as well. Isn't arthritis an old person's disease? This is also a very relevant question and asked by many. Well, it is unlike osteoarthritis, which is caused by wear and tear of the joints and usually affects the over-50s. On the contrary, Rheumatoid arthritis is basically an autoimmune disease, where the immune system goes into opposite and attacks certain parts of the body in place of protecting it.

Only in the realm of UK, in the region of 400,000 people has become vulnerable to the disease and it seems that a spate of the same is imminent. Try to note this down too. The dominance of the disease is three times more in women and can run in families.

What are the common symptoms? Symptoms range from very soft to severe and disabling. Joints become swollen and extremely agonizing and it can also affect organs such as the heart, lungs and eyes. Rheumatoid arthritis can start all of a sudden, but more often symptoms develop gradually. Persistent inflammation does exist also and can bring about joint damage over time and the joint may have to be replaced in severe cases.

Hence, if you are having any of the above-mentioned symptoms, it's time for you to contact the general practitioner in close proximity.

The national capital is seeing an alarming rise in the number of dengue cases, with 18 new cases reported Thursday. This takes the total number of confirmed cases of the vector-borne disease to 320, health officials said here.

'The number of dengue cases is rising. But considering that October is a time when dengue generally spreads fast because of the ideal atmosphere, the numbers are still lower than last year,' said N.K. Yadav, chief medical officer of the Municipal Corporation of Delhi (MCD).

On an average there have been 18-20 cases reported every day in the past few days, he added.

Until now, there have been two deaths reported because of the disease - a 15-year-old boy and a nine-year-old boy.

Delhi Health Secretary J.P. Singh said: 'The number of dengue cases in the capital is rising. However, the numbers are almost one-fifth of what was last year. We are taking all precautionary measures to check the spread of the disease like awareness programmes and doing door-to-door checks to stop mosquito breeding.'

However, doctors from private hospitals and pathological laboratories said that the number of dengue cases is much more than what has been reported.

An official of Dr. Dang's, a pathological laboratory said: 'All the numbers that the MCD has been quoting is only of those cases which have been confirmed in government hospitals. But if you go to any private hospital you will see that they are choc-a-bloc with dengue affected patients.'

President Barack Obama declared the swine flu outbreak a national emergency, giving his health chief the power to let hospitals move emergency rooms offsite to speed treatment and protect noninfected patients.

The declaration, signed Friday night and announced Saturday, comes with the disease more prevalent than ever in the country and production delays undercutting the government's initial, optimistic estimates that as many as 120 million doses of the vaccine could be available by mid-October.

Health authorities say more than 1,000 people in the United States, including almost 100 children, have died from the strain of flu known as H1N1, and 46 states have widespread flu activity. So far only 11 million doses have gone out to health departments, doctor's offices and other providers, according to the Centers for Disease Control and Prevention officials.

Administration officials said the declaration was a pre-emptive move designed to make decisions easier when they need to be made. Officials said the move was not in response to any single development.

Health and Human Services Secretary Kathleen Sebelius now has authority to bypass federal rules when opening alternative care sites, such as offsite hospital centers at schools or community centers if hospitals seek permission.

Some hospitals have opened drive-thrus and drive-up tent clinics to screen and treat swine flu patients. The idea is to keep infectious people out of regular emergency rooms and away from other sick patients.

Hospitals could modify patient rules - for example, requiring them to give less information during a hectic time - to quicken access to treatment, with government approval, under the declaration.

It also addresses a financial question for hospitals - reimbursement for treating people at sites not typically approved. For instance, federal rules do not allow hospitals to put up treatment tents more than 250 yards away from the doors; if the tents are 300 yards or more away, typically federal dollars won't go to pay for treatment.

Administration officials said those rules might not make sense while fighting the swine flu, especially if the best piece of pavement is in the middle of a parking lot and some medical centers already are putting in place parts of their emergency plans.

The national emergency declaration was the second of two steps needed to give Sebelius extraordinary powers during a crisis.

On April 26, the administration declared swine flu a public health emergency, allowing the shipment of roughly 12 million doses of flu-fighting medications from a federal stockpile to states in case they eventually needed them. At the time, there were 20 confirmed cases in the U.S. of people recovering easily. There was no vaccine against swine flu, but the CDC had taken the initial step necessary for producing one.

"As a nation, we have prepared at all levels of government, and as individuals and communities, taking unprecedented steps to counter the emerging pandemic," Obama wrote in Saturday's declaration.

He said the pandemic keeps evolving, the rates of illness are rising rapidly in many areas and there's a potential "to overburden health care resources."

The government now hopes to have about 50 million doses of swine flu vaccine out by mid-November and 150 million in December. The flu virus has to be grown in chicken eggs, and the yield hasn't been as high as was initially hoped, officials have said.

"Many millions" of Americans have had swine flu so far, according to an estimate that CDC Director Dr. Thomas Frieden gave Friday. The government doesn't test everyone to confirm swine flu so it doesn't have an exact count. He also said there have been more than 20,000 hospitalizations.

In a shocking incident, eyeballs of four persons were removed while the condition of six others who underwent a cataract surgery turned
critical due to the alleged negligence of doctors. Presently, they are undergoing treatment at Sankar Netralaya in Chennai.

Doctors in Chennai confirmed that the six patients have diminished vision after their eyes developed post-surgery complications. Ten patients underwent cataract surgery at Bollineni Global Eye Foundation Hospital in Nellore town on October 19. In all 34 underwent eye surgery since the camp started on Oct 18.

Trouble started after a patient complained of severe pain in the eyes and approached the hospital authorities on October 20 evening. With some more patients developing eye infection, they were shifted to Chennai on October 21 for further treatment. The patient's worst fears were confirmed when the doctors said eyeballs of four persons were badly infected and they need to be removed immediately to save their lives. Accordingly, their eyeballs were removed on October 23.

Serious doubts have cropped up over the safety measures taken during the cataract surgeries. "Saline contamination during post-surgery might have led to the eye infection," said an expert.

However, sources said the infection was caused by use of solutions during the surgery."We have sent the samples to the government labs for testing. We are sparing no efforts to save the eyesight of the six patients," Sai Murali, MD of Bollineni eye hospital told TOI.

He said even those whose eyeballs were removed could see with one eye. "This was an unfortunate incident and the causes for the infection were beyond our control," he said, claiming that 45,000 cataract surgeries have been performed in the hospital in the past six years.

Collector K Ramgopal said a specialist team of doctors has been sent to Chennai to collect the patients' swabs. "We have ordered a preliminary probe into the incident," he said. When contacted, district SP B Mallareddy said that no complaint has been filed against the hospital management by any of the patients or their kin. Sources said one of the patients was a doctor and he was also being treated in Chennai.

One of the many reasons to pick a low-calorie, low-fat diet rich in vegetables, fruits, and fish is that a host of epidemiological studies have suggested that such a diet may delay the onset or slow the progression of Alzheimer's disease (AD). Now a study published in BioMed Central's open access journal Molecular Neurodegeneration tests the effects of several diets, head-to-head, for their effects on AD pathology in a mouse model of the disease. Although the researchers were focused on triggers for brain plaque formation, they also found that, unexpectedly, a high protein diet apparently led to a smaller brain.

A research team from the US, Canada, and the UK tested four differing menus on transgenic mouse model of AD, which express a mutant form of the human amyloid precursor protein (APP). APP's role in the brain is not fully understood; however it is of great interest to AD researchers because the body uses it to generate the amyloid plaques typical of Alzheimer's. These mice were fed either

1. a regular diet,
2. a high fat/low carbohydrate custom diet,
3. a high protein/low carb version or
4. a high carbohydrate/low fat option.

The researchers then looked at the brain and body weight of the mice, as well as plaque build up and differences in the structure of several brain regions that are involved in the memory defect underlying AD.

Unexpectedly, mice fed a high protein/low carbohydrate diet had brains five percent lighter that all the others, and regions of their hippocampus were less developed. This result was a surprise, and, until researchers test this effect on non-transgenic mice, it is unclear whether the loss of brain mass is associated with AD-type plaque. But some studies in the published literature led the authors to put forward a tentative theory that a high protein diet may leave neurones more vulnerable to AD plaque. Mice on a high fat diet had raised levels of plaque proteins, but this had no effect on plaque burden.

Aside from transgenic mice, the pressing question is whether these data have implications for the human brain. "Given the previously reported association of high protein diet with aging-related neurotoxicity, one wonders whether particular diets, if ingested at particular ages, might increase susceptibility to incidence or progression of AD," says lead author, Sam Gandy, a professor at The Mount Sinai School of Medicine in New York City and a neurologist at the James J Peters Veterans Affairs Medical Center in the Bronx NY. The only way to know for sure would require prospective randomised double blind clinical diet trials. According to Gandy, "This would be a challenging undertaking but potentially worthwhile. If there is a real chance that the ravages of AD might be slowed or avoided through healthy eating. Such trials will be required if scientists are ever to make specific recommendations about dietary risks for AD."